Kalkman C J
Universitair Medisch Centrum Utrecht, divisie Perioperatieve Zorg en Spoedeisende Hulp, Postbus 85-500, 3508 GA Utrecht.
Ned Tijdschr Geneeskd. 2007 Feb 10;151(6):342-4.
Little scientific evidence is available on the continuation of psychotropic drugs in the perioperative period. Clinicians often have to rely on case reports and small case series. However, case reports of rare events, such as life-threatening interactions between psychotropic drugs and anaesthetics, do not provide reliable data on the frequency of such events and may lead to a rather defensive approach. Recommendations were published recently based on expert opinion from a multidisciplinary group. This proposal could be used for the development of an official, evidence-based guideline on the perioperative use of psychotropic drugs. The quality of such a guideline would be improved by prospective cohort studies that compare events in patients who discontinue psychotropic medication with those in patients who continue medication for fear of severe withdrawal symptoms.
关于围手术期继续使用精神药物的科学证据很少。临床医生往往不得不依赖病例报告和小型病例系列。然而，关于罕见事件的病例报告，如精神药物与麻醉剂之间危及生命的相互作用，并未提供此类事件发生频率的可靠数据，而且可能导致一种相当保守的处理方式。最近基于一个多学科小组的专家意见发表了相关建议。该提议可用于制定关于围手术期精神药物使用的官方循证指南。通过前瞻性队列研究来比较因担心严重戒断症状而停用精神药物的患者与继续用药的患者的情况，这样的指南质量将会得到提高。
